Provider Demographics
NPI:1609208487
Name:CUDDY, AMY RELICH (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:RELICH
Last Name:CUDDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DELVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4408
Mailing Address - Country:US
Mailing Address - Phone:302-521-4670
Mailing Address - Fax:
Practice Address - Street 1:1500 SHALLCROSS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-3037
Practice Address - Country:US
Practice Address - Phone:302-521-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000721103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist